干扰素-γ释放测定法作为在高负担国家中快速检测TB的有效辅助工具是可行的。在这项回顾性研究中,我们的目的是确定确诊活动性肺结核患者T-SPOT结果阴性的危险因素.
我们连续招募了1,021例抗酸杆菌涂片染色或培养证实的分枝杆菌感染阳性的患者,同时进行T-SPOT检测。TB测定。使用生物芯片测定将所有包括的标本用于区分分枝杆菌物种。我们收集了基本临床特征和实验室结果以进行进一步分析。
在参加研究的1,021名患者中,89例患者被鉴定为非结核分枝杆菌(NTM)。由于不确定的T-SPOT,99名患者被排除在分析之外。TB结果,而其余833例患者被确定为结核分枝杆菌感染。总的来说,159例患者T-SPOT假阴性。结核病结果(833例的19.1%)。T-SPOT之间的一致率。女性的结核病结果和最终诊断总是低于男性。多因素logistic回归分析显示,女性性别(OR1.81;95%CI1.19,2.7;p=0.006),年龄(OR1.02;95%CI1.01,1.03;p=0.003),抗酸杆菌(AFB)涂片阴性(OR5.45;95%CI3.62,8.19;p<0.001),HIV合并感染(OR6.83;95%CI2.73,17.10;p<0.001)与T-SPOT阴性相关。TB结果。
女性是T-SPOT阴性的另一个独立危险因素。TB结果,除了长者,艾滋病毒共同感染,抗酸杆菌(AFB)涂片阴性,怀疑患有活动性TB感染。
The interferon-γ release assays as potent adjunct tools for the quick detection of TB in high burden countries is feasible. In this retrospective study, we aimed to identify the risk factors for negative T-SPOT results in confirmed active tuberculosis.
We consecutively enrolled 1,021 patients who were positive for acid-fast bacilli smear staining or culture-confirmed mycobacterial infection and simultaneously tested with the T-SPOT.TB assay. All of the included specimens were used to discriminate the Mycobacterium species using the biochip assay. We collected basic clinical characteristics and laboratory results for further analysis.
Of the 1,021 patients enrolled in the study, 89 patients were identified as having nontuberculous mycobacteria (NTM). Ninety-nine patients were excluded from the analysis because of indeterminate T-SPOT.TB results, while the remaining 833 patients were identified as having Mycobacterium tuberculosis infection. In total, 159 patients had false-negative T-SPOT.TB results (19.1% of 833). The concordance rate between the T-SPOT.TB results and final diagnoses in females was always lower than that in males. Multivariate logistic regression analysis showed that female sex (OR 1.81; 95% CI 1.19, 2.7; p = 0.006), age (OR 1.02; 95% CI 1.01, 1.03; p = 0.003), acid-fast bacilli (AFB) smear-negative (OR 5.45; 95% CI 3.62, 8.19; p < 0.001), HIV coinfection (OR 6.83; 95% CI 2.73, 17.10; p < 0.001) were associated with negative T-SPOT.TB result.
Female is another independent risk factor of negative T-SPOT.TB results, besides to elder, HIV co-infection, acid-fast bacilli (AFB) smear-negative who are suspected of having active TB infection.